A Prospective Randomized Double-Blind Study Comparing Hemodynamic Responses to Laryngoscopy and Endotracheal Intubation Following Induction with Propofol and Etomidate

Background: Laryngoscopy and endotracheal intubation are essential elements of general anesthesia, inducing considerable sympathetic activation, which leads to tachycardia and hypertension. These temporary changes in blood flow may lead to significant heart problems, especially in those whose hearts aren't very strong. The selection of the induction agent is essential in influencing these responses. Propofol and etomidate are frequently utilized intravenous induction medications exhibiting distinct cardiovascular characteristics. The current study was conducted to examine the hemodynamic responses to laryngoscopy and endotracheal intubation following the induction of general anesthesia with propofol and etomidate in patients undergoing elective major abdominal operations. Material and Methods: This prospective, randomized, double-blind clinical trial involved 100 adult patients aged 18–60 years, classified as American Society of Anesthesiologists (ASA) physical status I and II, and scheduled for elective major abdominal procedures under general anesthesia. Patients were randomly assigned to two groups: Group P got propofol 2 mg/kg intravenously, and Group E received etomidate 0.3 mg/kg intravenously for induction. At baseline, after induction, during laryngoscopy, and at 1, 3, 5, and 10 minutes after endotracheal intubation, we measured heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and oxygen saturation (SpO₂). Negative effects were also recorded. Results: The baseline demographic features and hemodynamic indicators were similar across the two groups (p > 0.05). After laryngoscopy and intubation, both groups saw a big rise in HR, SBP, DBP, and MAP. However, the rise was much bigger in the propofol group at 1 and 3 minutes after intubation (p < 0.05). Etomidate exhibited enhanced hemodynamic stability during airway manipulation. Oxygen saturation stayed steady and similar between the two groups for the whole investigation. Conclusion: Etomidate offers superior hemodynamic stability relative to propofol during laryngoscopy and endotracheal intubation, and may be favored as an induction drug in individuals for whom cardiovascular stability is critically important.

Keywords: Propofol; etomidate; hemodynamic response; laryngoscopy; endotracheal intubation; general anesthesia.